Nadine Graham

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

122510034102 Issued in UT

Practice address

1034 N 500 W
Provo, UT 84604-3380

Phone

(801) 357-7414

NPI assigned

Apr 12, 2018

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1700383908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8848 N LAKESHORE DR",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749787",
            "telephone_number": "267-614-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "NADINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL013684",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "122510034102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Therapy & Healing PLLC (Grace Therapy & Healing)
• William R Graden, MD
• Justin Wallace Graf, MD
• Dan Graham, MS, ATC, EMT
• Laura Graham
• Nicole Coleeen Granados, FNP
• Grandpa's Dental Inc.
• Morgan K Grant, MD
• Aubrie Ann Grass
• Cynthia Graves, LCSW

• Speech-Language Pathologist in Provo, UT
• Providers in Provo, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.